Rethinking pharmaceutical corruption in the age of ghost management: a broader approach to combating corruption

The pharmaceutical industry operates within a complex and highly regulated environment, where even minor technical or regulatory decisions related to safety, effectiveness, intellectual property, and reimbursement can shift billions of dollars in revenue. Given the financial stakes, various questionable corporate strategies and corrupt practices are deployed to influence regulatory processes or prescribing behaviors, ultimately prioritizing profit over public health. However, actions that compromise the public interest and distort medical knowledge—such as shaping public policy to benefit private pharmaceutical corporations—are often excluded from narrow definitions of corruption. This study introduces a broader concept of corruption to better analyse the behind-the-scenes dynamics in the sector and identifies the principal modes of capture mechanism in the pharmaceutical sector, the main fields in which these strategies are applied, and explores the main priorities for combating corruption. The well-being of patients and the improvement of health outcomes should remain paramount in shaping the pharmaceutical sector through public policy.